Hui Luo,1 Jinbao Ma,1 Xiaomou He,1 Yunzhou Ruan,2 Fei Ren,1 Liyun Dang,1 You Xu,1 Ali Zhao1 

1Department of Drug-Resistance Tuberculosis, Xi’an Chest Hospital, Xi’an, 710100, People’s Republic of China; 2National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China

Correspondence: Ali Zhao, Department of Drug-resistance tuberculosis, Xi’an Chest Hospital, East Section of Hang Tian Avenue, Chang’an District, Xi’an, Shaanxi, 710100, People’s Republic of China, Tel +86-18192105257, Email zal08260705@163.com

Objective: A hospital in Xi’an, Shaanxi Province, China, implemented patient-centered care services to improve the treatment outcomes of patients with multidrug-resistant/rifampicin-resistant tuberculosis. Given the high recurrence rate and treatment challenges of this disease, this study aimed to evaluate the effects of patient-centered care services compared to standard care in improving patient treatment adherence and reducing loss to follow-up.
Methods: This single-center retrospective cohort study included multidrug-resistant/rifampicin-resistant tuberculosis patients diagnosed and treated at the Xi’an Tuberculosis Prevention and Treatment Hospital from January 2018 to December 2019. Descriptive statistics, survival analysis, and multivariate Cox regression analysis were used to analyze the impact of patient-centered care services on treatment adherence. Data collection included patients’ demographic characteristics, clinical data, treatment outcomes, and reasons for loss to follow-up.
Results: A total of 429 patients were included in the final analysis, with 166 in the standard-of-care group and 263 in the patient-centered care services group. The treatment success rate in the patient-centered care services group (86.3%) was significantly higher than the standard of care group (59.0%), and the loss to follow-up rate was significantly lower (6.8% vs 30.1%). Multivariate analysis showed that patient-centered care services significantly reduced the risk of loss to follow-up (adjusted odds ratio of 0.14). The main reasons for the loss of follow-up included economic difficulties, lack of knowledge, and inadequate social support.
Conclusion: The patient-centered care services model significantly improved the treatment success rate and reduced the loss to follow-up rate for multidrug-resistant/rifampicin-resistant tuberculosis patients, demonstrating potential benefits in managing drug-resistant tuberculosis. Based on these findings, exploring and optimizing the patient-centered care services model in other high-burden areas is recommended to enhance overall treatment outcomes and quality of life for patients.

Keywords: multidrug-resistant tuberculosis, rifampicin-resistant tuberculosis, loss to follow-up, patient-centered care, survival analysis, treatment adherence